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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206604
Report Date: 10/04/2021
Date Signed: 10/04/2021 06:17:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MAGNOLIA PARK ASSISTED LIVINGFACILITY NUMBER:
547206604
ADMINISTRATOR:GONZALEZ, ARNULFOFACILITY TYPE:
740
ADDRESS:2950 E. DOUGLAS AVE.TELEPHONE:
(559) 625-6001
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY:59CENSUS: 18DATE:
10/04/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Licensee Esperanza Hansen; Administrator Arnulfo GonzalezAttorney
Justin D. Harris; 		TIME COMPLETED:
04:30 PM
NARRATIVE
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Administrator Esperanza Hansen initiated an Office Meeting on this date to discuss the Court's approval of motion to appoint a receiver & the 9/30/2021 notification of the Court signed version of the order.

Present during the meeting:
  • Esperanza Hansen, Licensee (L);
  • Arnulfo Gonzalez, Administrator (Admin);
  • Justin D Harris, Attorney (Atty);
  • Brenda White, Regional Manager (RM);
  • See Moua, Licensing Program Manager (LPM);
  • Sergiy Pidgirny, Licensing Program Manager (LPM);
  • Kelly McClurg, Licensing Program Analyst (LPA);

Outcome
  • Licensee is still in control of the facility;
  • Licensee scheduled Court date of 11/9/21 to review for reconsideration of receivership. Court date scheduled for 11/9/21;
  • Licensee's lawsuit/court trial for Title/Control dispute is scheduled for 11/29/21 (CCL will be notified of any changes);
  • No interruption of services at facility including utilities, electricity, & water;

Continued.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: MAGNOLIA PARK ASSISTED LIVING
FACILITY NUMBER: 547206604
VISIT DATE: 10/04/2021
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Continued from page 1.


Requested
  • Court Documents/Transcript of stay of Unlawful Detainer;
  • Court Documents/Transcript regarding Receivership;
  • Mitigation Place LIC808
  • Emergency Disaster Plan LIC610E

Requested items to be submitted by: October 8, 2021


Exit interview conducted with L & Admin. Report provided.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
LIC809 (FAS) - (06/04)
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